Initiating a Plan, Do, Study and Act (PDSA) Cycle to Improve Diabetes Care in Kasr Al-Aini Hospital, Egypt
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- Category: Vol. 84, December 2016
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Initiating a Plan, Do, Study and Act (PDSA) Cycle to Improve Diabetes Care in Kasr Al-Aini Hospital, Egypt, FOUAD H.A. OTHMAN, NAFOSSA A. AFIFFY, AMR A. MELEGY and OLA A. MOSTAFA
Abstract
Background: Successful quality improvement using Plan-Do-Study-Act (PDSA) cycles have been noted in many fields including diabetes care. Diabetes is a costly disease in terms of morbidity, mortality and quality of life placing an enormous economic and health burden worldwide. Quality care for diabetes with regular follow-up is a corner stone for proper glycemic control and better quality of life.
Objective: To improve the quality diabetes services through using the (PDSA) quality improvement process.
Method: This study is a quality improvement intervention study using PDSA model to initiate a pilot improvement cycle for diabetes care. The study has passed into 4 phases according to the PDSA model between September 2013 to December 2014. It was conducted at outpatient clinic in Diabetes and Endocrine Center (DEC) in Cairo, Egypt. It is as a referral center affiliated to Kasr Al-Aini University Hospital (KAUH) providing ambulatory care to diabetic patients. Diabetic patients attending the DEC at KAUH for regular follow-up visits. Two groups of patients (104 Vs. 50) and (100 Vs. 93) aged (18-65 year) were randomly selected for the new design and self-care education interventions respectively.
A new follow-up sheet design and a self-care education program were implemented for 3 months. The outcome mea-sures include; physicians process performance, patients' knowledge and practices, diabetes clinical indicators and patients' satisfaction.
Results: A significant improvement in physicians' perfor-mance was noticed after implementation of the new sheet regarding history taking, physical examination (BP, body weight, and foot examination), referrals to dietitians and to ophthalmologists, as well as follow-up investigations (A1C% and lipid profile).
A significant improvement of total knowledge score was observed among patients from median (IQR) 10 (8-12) to 15 (14-17) after the intervention (p=0.000), in addition to a significant increase in the number of patients who always follow healthy dietary habits (p=0.000). A significant reduction in mean BMI, SBP and A1C% was observed after the inter-vention (p=0.000, p=0.000 and p=0.001) respectively.
Conclusion: The current study revealed that PDSA model is a valuable method to improve the diabetes services. Imple-mentation of the new sheet design as well as self education had a positive impact on diabetes care and patients clinical outcomes and satisfaction.